Esophageal pH monitoring/BRAVO
Stomach acid that refluxes into the esophagus can be measured to diagnose GERD and determine its severity. A small, wireless chip the size of a pencil eraser is clipped to the lining of the esophagus. This chip sends information to a small receiver for 2 days. The chip then falls off and passes out through the GI tract unknowingly.
Placing the Bravo Chip
Esophageal Manometry
This test measures the pressures in the esophagus upon swallowing. A thin catheter is placed down the nose into the stomach after the application of numbing medicine. Water is sipped and the pressures are recorded. Normally, the pressure that moves down the esophagus is a wave.
Abnormalities may include simultaneous and irregular contractions. Sometimes, the esophagus doesn’t relax impeding the normal transit of food into the stomach. These abnormalities may cause difficulty swallowing or chest pain.
Manometry Showing Esophageal Pressures
Esophageal Manometry
Achalasia
Nutcracker Esophagus
Radiofrequency ablation
GERD can damage the lining of the esophagus and lead to changes that increase the risk of cancer. This is called Barrett’s esophagus. Barrett’s esophagus must be surveyed annually with EGD and multiple biopsies to detect progression to cancer. A new treatment that I perform removes Barrett’s esophagus endoscopically (without surgery).
90 Degree RFA Device
360 Degree RFA Device
